Among American health trends, kava has yet to be embraced like wheatgrass or the Palaeolithic diet.

A traditional staple of Polynesian ceremonies, it's made by pulverizing the roots of the kava plant into an earthy, somewhat bitter beverage that boasts sedative, anesthetic, and euphoriant properties. Users are not exactly high, they say, but the drink does leave them feeling relaxed, engaged, and very social.

What's more, according to kava enthusiasts, is that the drink can help any number of bodily issues ranging from muscle soreness and inflammation to acute aches and pains.

The drink is made from the roots of the kava plant, which are typically dried and pulverized. The plant (right) takes up to five years to mature, which has been a deterrent for farmers

Kava is native to the South Pacific and boasts sedative, anesthetic, and euphoriant properties

Dried kava root (pictured) is pulverized and soaked for 15 minutes or so before being pressed, kneaded and squeezed through a strainer. Once the pulp is removed, it's ready to drink

At a time when the dangerous, addictive effects of prescription opiates and other drugs have become headline news, kava is offering professional and amateur jocks an important alternative that's legal in the United States and only slightly more regulated in Europe.

There have been concerns that kava can cause liver damage, which led the FDA to issue a consumer advisory in 2002 while Germany and several European countries banned it altogether. However, the World Health Organization has since concluded that there 'is little documented evidence of adverse health effects associated with traditional moderate levels of consumption of kava beverage.'

Today most European countries have overturned any ban on the root.

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'I always gravitated to it, not just as a social lubricant, but also for the relaxing effect after a stressful day or a sports-related injury – especially inflammation. It's known as a natural anti-inflammatory,' explained Matthew Masifilo, a former Stanford University defensive lineman who switched to the offensive line during a brief NFL career with the Tampa Bay Buccaneers.

'There's a lot of side effects of those opioids and anti-inflammatories,' continued Masifilo, who battled knee problems at Stanford. 'It's really tough on your stomach. I'd feel sick from them and I just didn't like the side effects. If it was [a small injury], I would try to stick to natural alternatives unless it's something extremely critical with pain management where you have no choice.'

Matthew Masifilo (right) turned many former football teammates on to kava because it works as a 'social lubricant,' he said, and for all of its practical purposes like pain and anxiety relief

Masifilo is a native Hawaiian of Tongan descent who founded Kavafied, a company that runs a commercial farm in Tonga and sells other items connected to kava consumption

Like many football players of Polynesian descent, Masifilo was hardly new to kava when he began using it for pain relief and sharing it with his uninitiated teammates during his playing days.

A native of Hawaii, Masifilo's father hails from Tonga, one of a handful of countries in the Pacific that are responsible for the entire world's kava production.

IS KAVA SAFE?

Kava is more or less unregulated in America, although the Federal Drug Administration did issue a consumer advisory in 2002 that warned of potential liver damage. Germany officially banned kava altogether in 2011 (after effectively banning it a decade earlier) only to legalize it again in 2015 after the studies that suggested it was dangerous in the first place came under scrutiny.

In 2007, the World Health Organization pointed to kava extracts and other factors such as ‘excessive alcohol intake, metabolic or immune mediated idiosyncrasy, excessive dose or pre-existing liver disease’ as the primary causes for the ‘rare occasions’ when liver damage was discovered. Specifically, kava byproducts made from acetonic and ethanolic extracts were linked to liver damage.

More recently, the WHO as well as the Food and Agriculture Organization of the United Nations all but exonerated kava.

‘On balance, the weight-of-evidence from both a long history of use of kava beverage and from the more recent research findings indicates that it is possible for kava beverage to be consumed with an acceptably low level of health risk,’ read the technical report, which stated that further studies are necessary to ensure safe use.

With most of the bureaucratic hurdles aside, kava is starting to gain popularity again.

‘Common sense would tell you that Kava has been consumed for 3,000 years,’ said Matthew Masifilo, a former NFL player and kava entrepreneur. ‘There’s entire cultures that drink it nightly. And you’re going to tell me that it’s killing people?’

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In Tonga, kava is consumed in a variety of settings, from casual community gatherings, to kava drinking ceremonies, and even kava clubs called 'kalapus.'

'The men in the village meet at the end of the day and drink kava and discuss all the social issues,' said Masifilo. 'And then you have other kava ceremonies that are used to honor someone. It's a little bit more formal. They're for weddings [and such]. Then you have the even bigger kava ceremonies - the royal ones where there's even more formalities. They're used to coronate the king or the passing of a royal family member.'

Like champagne, kava is used in celebrations, as it was during the 2016 Summer Olympics when the Fijian rugby team indulged during a ceremony immediately after the players received their gold medals.

The publicity came at the perfect time for the kava industry.

A year earlier, Germany lifted its four-year ban on kava after previous studies that linked it to liver damage were dismissed as misleading. Since then, the root has seen a resurgence in Europe and North America.

Now there are more than 100 kava bars in the United States, which is up from around 30 in 2012, according to The New York Times.

And while the contents of the drink have remained the same, kava is getting repurposed in the west, where it's often used as an alternative to the minor tranquilizer Xanax for the mellow, relaxing feeling it provides.

'I think this year, it has really boomed,' said Harding Stowe, owner of Brooklyn Kava in New York. 'There's a lot of information out now, a lot of articles on it. A lot of people are reading about it. They're curious and they want to try it.'

According to Stowe, around 10 or 15 percent of his clientele use kava for physical pain, including one kava devotee who relied on it after having ACL surgery on his knee rather than taking prescription opiates. 'It was effective enough to work,' said Stowe.

Kava also benefits from being non-drowsy, unlike many prescription opioids which can affect motor skill.

That means after using kava, it's still safe to drive or do just about anything - even 'skateboarding,' as one Brooklyn Kava employee, Alex Crawford, put it.

And because it's non-drowsy, it doesn't matter when you take it. Brooklyn Kava, for instance, is open from 9am until midnight, making the establishment something of a hybrid between a café and a bar.

Naturally bitter and earthy, kava is usually consumed with a fruit juice chaser (left). However, some bars like Brooklyn Kava do offer kava cocktails (right) that are a bit more complex

Kava bars are open throughout the day and night so they feel like a cross between a traditional bar and a cafe. Many even offer growlers for kava aficionados to take home

Because kava isn't as intoxicating as alcohol, it can be consumed at any time of day. And since it's non-drowsy, some people choose to drink it before the gym because it relaxes muscles

Stowe is even negotiating with a nearby yoga studio to incorporate kava into one of its classes, but he and his partners aren't sure if it's better to serve the yogis before or afterward.

'I take it before the gym,' said Dutch Welch, a regular customer at Brooklyn Kava. 'I work out a lot and it gave me more energy to push through the wall. It's better than taking a lot of the pre-workout [supplements] because they can be bad on your liver.

HOW TO MAKE AND CONSUME KAVA

Kava can be used in a number of ways, but the most popular is in its traditional liquid form, which typically comes in a small bowl.

The process starts with the kava roots, which are either freshly picked – if you’re in the South Pacific – or ground, shredded, or powdered. Around 99 percent of kava used outside the South Pacific falls into the latter category.

It’s then soaked for at least 15 minutes before being pressed, kneaded and squeezed through a strainer.

‘We put them in strainer bags, these nut milk bags, submerge them in water and then knead them when they’re under water’ said Harding Stowe, owner of Brooklyn Kava.

Once the liquid looks almost like coffee with cream, kava pulp is removed or put through a metal strainer.

From there it’s really up to the consumer. Some establishments, like Brooklyn Kava, do kava cocktails or serve it alongside some kind of fruit juice, which is used to cut the somewhat bitter taste.

Having over 30 or so ounces of kava in a day isn’t recommended, but according to Stowe, that’s never a problem.

‘If you consume a very large amount of Kava, you’ll get tired,’ he said. ‘That’s about it.’

Another interesting thing about kava is that it differs from drugs or alcohol in that its users don’t develop a higher tolerance. If anything, frequent kava use reduces one’s tolerance.

‘The more kava you drink over time, the less you will need,’ said Stowe.

It also doesn’t leave you with a hangover, although some say it has a subtle effect for a day after its use.

'I don't pull muscles and I'm not tense,' Welch continued. 'I'm already loosened up by the time I get there. I definitely notice I don't get injured as much. Everybody gets injured, but I don't as much.'

Different strains of kava are best used for different purposes.

Tongan kava, for instance, is high in kavain, one key kavalactone – or lactone compound – found in kava.

'That has a numbing effect,' said Masifilo, whose family has owned a kava farm in Haatua, Kolomaile, 'Eua, Tonga for generations.

As Masifilo explained, Kava's versatility can be credited, in part, to its own diversity.

'Kava is more similar to marijuana,' said Masifilo. 'There are over 100 different strains that have variations… Over time the farmers have picked out the mutations they liked for different effects and have isolated different cultivars to meet different societal needs.'

As Stowe explained, the different regions produce distinctly different flavors and effects.

'Fijian kava is a bit more uplifting and energetic,' said Stowe. 'It's kind of more of a daytime Kava, whereas some other strains like Vanuatu or Hawaii are a bit more – I don't want to say sedating – they're more relaxing.'

So while some kava is better for pain, others do a better job of relieving anxiety, creating a mild sense of euphoria or reducing inflammation.

Kava also benefits from the fact that professional sports leagues have yet to ban it, so players can utilize the bitter brew without fear of failing a drug test. And maybe equally important, kava offers a social outlet for players without the dangers of alcohol or illegal drugs.

Several Miami Dolphins players, including three-time Pro Bowl center Mike Pouncey, have stated publicly that they use kava as an alternative to opioids.

'Hell yeah, I drink a lot of kava - Koa Misi and Paul Soliai are my guys,' Pouncey told The Palm Beach Post, referring to former teammates of Polynesian descent. 'It's like taking a bunch of like muscle relaxers. You're tongue goes numb right away.'

And as NESN reported, New England Patriots owner Robert Kraft stumbled upon several players enjoying kava together in the locker room days before their AFC Championship Game win over the Indianapolis Colts in December of 2014.

'The Polynesian guys on the team drink a drink – Kava or something, and there were 18 [players in the corner of the locker room,]' Kraft said. 'And it was late afternoon, and they were just joshing around and having fun. It was really special.'

It's also being used by college football teams like the Utah Utes – a roster that typically features several players of Polynesian descent. But that doesn't mean it's just for players who trace their roots to the South Pacific. In 2015, most of the Utes players began having team kalapus in the 48 hours before a game.

The biggest problem facing the kava industry is supply, according to Masifilo

Over the last few years, kava supplements have been increasingly marketed towards the fitness crowd, although there remains some debate about the overall safety and effectiveness of those products.

But while kava is growing in popularity among professional and amateur athletes, there are some hurdles facing the industry.

First, the price of the raw root has skyrocketed in recent years following its legalization in Germany coupled with its own growing popularity.

In the last 3 or 4 years, the cost of kava has more than quadrupled

Matthew Masifilo

Making matters worse, a cyclone nearly decimated Vanuatu's entire kava crop in 2015. And since the plant can take as long as five years to mature, some farmers responded by choosing to plant crops that offer a quicker yield.

Then there was a drought caused by El Nino in 2016 that severely hampered production in Fiji, Tonga and Micronesia.

'In the last 3 or 4 years,' said Masifilo, 'the cost of kava has more than quadrupled.'

In Fiji, for instance, the price more than doubled to $18 a pound locally between 2016 and 2017, according to The New York Times.

And because kava can spoil once it's been processed into liquid form, it can be difficult to store large quantities. That's why some kava bars, like Brooklyn Kava, offer growlers that can be refrigerated for short periods of time.

Those who don't live near kava bars can purchase the root or kava byproducts online or at local health stores. The problem is that preparing kava is a very labor-intensive activity and most busy Americans do not have the time to knead and squeeze the roots after immersing them in water for 15 or 20 minutes.

Masifilo, who happens to have an engineering degree from Stanford, believes he came up with the solution in 2014 when he invented the AluBall.

The product gets its name from 'Alu,' the Tongan verb meaning 'to go,' and allows users to drop in a couple of servings and shake the device for a minute or two to prepare kava in a fraction of the time.

Veteran center Mike Pouncey is one of several Miami Dolphins players who uses kava

'It fits the Western Culture technology of getting things instantly and on demand,' laughed Masifilo. 'You're still able to enjoy the kava beverage in its traditional form and it's the easiest way to make kava now.'

Masifilo also sells kava directly off of his family farm in Tonga, which he turned into a commercial wholesaler with financing from the company he started, Kavafied.

By offering the raw materials and the AluBall, which allows for quicker preparation, such a company could make kava accessible to a new generation of athletes. A supposedly safe, natural painkiller and anti-inflammatory that loosens muscles and alleviates anxiety while promoting social, team-building behavior is a no-brainer for both professionals and amateurs.

But as South Pacific farmers can attest, the kava industry is at the mercy of the region's violently erratic weather patterns. That's why, according to Masifilo, researching sustainable ways to cultivate the plant is the best way to protect the industry.

'The only barrier is the supply of kava,' he said. 'The supply will always limit its growth.'